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In Korean culture, co-sleeping of parents and children are quite common, which is different from the Western culture where solitary sleeping of children is preferred. In this study, we evaluate the sleep environment factors that effect on children sleep disorder, and parent's parenting stress and mental health.
Surveys were conducted to 115 participating parents of preschool children sleeping behaviour lecture. Seventy-one completed surveys were analyzed for the study. The mean age of target children was 53 ± 23 months. Parents’ mental health was evaluated by using several forms such as Insomnia Severity Index, Korean-Parenting Stress Index short form, and The Patient Health Questionnaire-9. Children's sleeping environment and quality were assessed by Child Sleep Habit Questionnaire and Sleep environment survey.
Pearson correlation analysis (P < 0.05) was conducted to evaluate the relationship between the sleep disorder of children, and the parent's parenting stress and mental health. Analyzing the data through the partial least square path modeling, co-sharing would have negative effect; bed-sharing could have negative effect on the depressing emotion of parents (P = 0.065). Solitary sleeping of children could have positive effect on parent's mental health (P < 0.01).
Preschool children's sleeping disorder occurs more often in co-sleeping children with parents than solitary sleeping children. Parents’ parenting stress is related to the parent's age and depression, further related to the children sleeping disorder and their sleep environment. Although, it is difficult to generalize the exact cause, evaluation and improvement of children's sleep environment would help to reduce the parent's parenting stress.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Treatment for hoarding disorder is typically performed by mental health professionals, potentially limiting access to care in underserved areas.
We aimed to conduct a non-inferiority trial of group peer-facilitated therapy (G-PFT) and group psychologist-led cognitive–behavioural therapy (G-CBT).
We randomised 323 adults with hording disorder 15 weeks of G-PFT or 16 weeks of G-CBT and assessed at baseline, post-treatment and longitudinally (≥3 months post-treatment: mean 14.4 months, range 3–25). Predictors of treatment response were examined.
G-PFT (effect size 1.20) was as effective as G-CBT (effect size 1.21; between-group difference 1.82 points, t = −1.71, d.f. = 245, P = 0.04). More homework completion and ongoing help from family and friends resulted in lower severity scores at longitudinal follow-up (t = 2.79, d.f. = 175, P = 0.006; t = 2.89, d.f. = 175, P = 0.004).
Peer-led groups were as effective as psychologist-led groups, providing a novel treatment avenue for individuals without access to mental health professionals.
Declaration of interest
C.A.M. has received grant funding from the National Institutes of Health (NIH) and travel reimbursement and speakers’ honoraria from the Tourette Association of America (TAA), as well as honoraria and travel reimbursement from the NIH for serving as an NIH Study Section reviewer. K.D. receives research support from the NIH and honoraria and travel reimbursement from the NIH for serving as an NIH Study Section reviewer. R.S.M. receives research support from the National Institute of Mental Health, National Institute of Aging, the Hillblom Foundation, Janssen Pharmaceuticals (research grant) and the Alzheimer's Association. R.S.M. has also received travel support from the National Institute of Mental Health for Workshop participation. J.Y.T. receives research support from the NIH, Patient-Centered Outcomes Research Institute and the California Tobacco Related Research Program, and honoraria and travel reimbursement from the NIH for serving as an NIH Study Section reviewer. All other authors report no conflicts of interest.
Africa is experiencing a rapid increase in adult obesity and associated cardiometabolic diseases (CMDs). The H3Africa AWI-Gen Collaborative Centre was established to examine genomic and environmental factors that influence body composition, body fat distribution and CMD risk, with the aim to provide insights towards effective treatment and intervention strategies. It provides a research platform of over 10 500 participants, 40–60 years old, from Burkina Faso, Ghana, Kenya and South Africa. Following a process that involved community engagement, training of project staff and participant informed consent, participants were administered detailed questionnaires, anthropometric measurements were taken and biospecimens collected. This generated a wealth of demographic, health history, environmental, behavioural and biomarker data. The H3Africa SNP array will be used for genome-wide association studies. AWI-Gen is building capacity to perform large epidemiological, genomic and epigenomic studies across several African counties and strives to become a valuable resource for research collaborations in Africa.
We describe the case of an infant who was a late presenter of transposition of the great arteries where we proceeded with ductal stenting to improve oxygenation and left ventricle training. Stenting improved the infant’s saturation while keeping the left ventricle well trained for 4 months after the procedure. This report demonstrates that intermediate-term left ventricle training can be achieved via ductal stenting.
Dense thin β/β’’-alumina electrolyte films of less than 50 μm thickness were fabricated using vacuum dip-coating on porous substrate tubes. The porous substrate tubes were fabricated using a slip casting method. Fine Na-β/β’’-alumina powder was obtained via traditional solid state reaction processing. It was found that vacuum dip-coating is an effective method for fabricating thin dense layers coated on the porous tube. The mechanical properties of the porous tube, with and without the dense layer, were tested using a C-ring method. The optimized sintering process was also studied.
To evaluate the reliability and validity of a standardized measure of healthcare personnel (HCP) influenza vaccination.
Acute care hospitals, long-term care facilities, ambulatory surgery centers, physician practices, and dialysis centers from 3 US jurisdictions.
Staff from 96 healthcare facilities randomly sampled from 234 facilities that completed pilot testing to assess the feasibility of the measure.
Reliability was assessed by comparing agreement between facility staff and project staff on the classification of HCP numerator (vaccinated at facility, vaccinated elsewhere, contraindicated, declined) and denominator (employees, credentialed nonemployees, other nonemployees) categories. To assess validity, facility staff completed a series of case studies to evaluate how closely classification of HCP groups aligned with the measure's specifications. In a modified Delphi process, experts rated face validity of the proposed measure elements on a Likert-type scale.
Percent agreement was high for HCP vaccinated at the facility (99%) and elsewhere (95%) and was lower for HCP who declined vaccination (64%) or were medically contraindicated (64%). While agreement was high (more than 90%) for all denominator categories, many facilities' staff excluded nonemployees for whom numerator and denominator status was difficult to determine. Validity was lowest for credentialed and other nonemployees.
The standardized measure of HCP influenza vaccination yields reproducible results for employees vaccinated at the facility and elsewhere. Adhering to true medical contraindications and tracking decimations should improve reliability. Difficulties in establishing denominators and determining vaccination status for credentialed and other nonemployees challenged the measure's validity and prompted revision to include a more limited group of nonemployees.
Longitudinal, patient-level data on resource use and costs after an ischemic stroke are lacking in Canada. The objectives of this analysis were to calculate costs for the first year post-stroke and determine the impact of disability on costs.
The Economic Burden of Ischemic Stroke (BURST) Study was a one-year prospective study with a cohort of ischemic stroke patients recruited at 12 Canadian stroke centres. Clinical history, disability, health preference and resource utilization information was collected at discharge, three months, six months and one year. Resources included direct medical costs (2009 CAN$) such as emergency services, hospitalizations, rehabilitation, physician services, diagnostics, medications, allied health professional services, homecare, medical/assistive devices, changes to residence and paid caregivers, as well as indirect costs. Results were stratified by disability measured at discharge using the modified Rankin Score (mRS): non-disabling stroke (mRS 0-2) and disabling stroke (mRS 3-5).
We enrolled 232 ischemic stroke patients (age 69.4 ± 15.4 years; 51.3% male) and 113 (48.7%) were disabled at hospital discharge. The average annual cost was $74,353; $107,883 for disabling strokes and $48,339 for non-disabling strokes.
An average annual cost for ischemic stroke was calculated in which a disabling stroke was associated with a two-fold increase in costs compared to NDS. Costs during the hospitalization to three months phase were the highest contributor to the annual cost. A “back of the envelope” calculation using 38,000 stroke admissions and the average annual cost yields $2.8 billion as the burden of ischemic stroke.
Background: Patient satisfaction surveys conducted in English exclude respondents who are not proficient in the English language. This makes it difficult to assess whether health care services provided are culturally appropriate. This study aims to evaluate the level of satisfaction for Chinese speaking patients who received radiation treatments at the British Columbia Cancer Agency, Vancouver Centre in Canada.
Patients and Methods: Chinese patients were given a translated patient satisfaction survey on a voluntary basis to complete at the end of treatment. Contingency table analysis using the Pearson chi-square test or Fisher’s exact test was performed at 5% significance level for all analyses. Logistic regression analysis was conducted to investigate whether complete satisfaction with an aspect of care influenced overall satisfaction with services provided by the RT team.
Results: The level of satisfaction in Chinese speaking patients was lower compared to English speaking patients. The results from the Chinese survey also identified the importance of treatment patients with courtesy and providing them with a pleasant wait area.
Conclusions: Despite a language barrier, Chinese speaking patients still contributed to improvement initiatives at the Vancouver Centre. Efforts to ensure a culturally appropriate environment and provision of services include recruitment of staff members who reflect the cultural diversity of the community serviced, use of interpreter services or bilingual health providers for clients, use of linguistically appropriately education materials, and health care settings that is pleasant and respects the cultural diversity of the population serviced. This assessment provided a better understanding of whether services at the Vancouver Centre were culture appropriate.
We present a rapid and sensitive surface acoustic wave (SAW) immunosensor that utilizes gold staining as a signal enhancement method. A sandwich immunoassay was performed on sensing area of the SAW sensor, which could specifically capture and detect cardiac markers (cardiac troponin I (cTnI), creatine kinase (CK)-MB, and myoglobin). The analytes in human serum were captured on gold nanoparticles (AuNPs) that were conjugated in advance with detection antibodies. Introduction of these complexes to the capture antibody-immobilized sensor surface resulted in a classic AuNP-based sandwich immunoassay format that has been used for signal amplification. In order to achieve further signal enhancement, a gold staining method was performed, which demonstrated that it is possible to obtain gold staining-mediated signal augmentation on a mass-sensitive device. The sensor response due to gold staining varied as a function of cardiac marker concentration.
Highly mesoporous TiO2 nanoparticles (NPs) were synthesized by an aero-sol-gel process in this approach. By varying the mass fraction of inorganic templates, the formation of mesoporous TiO2 NPs with optimized surface area and pore volume distributions was examined. Then, the photovoltaic properties of the resulting mesoporous TiO2 NPs were systematically investigated by applying them into the photoanode of dye-sensitized solar cells (DSSCs). The mesoporous TiO2 NP-based DSSCs fabricated in this study showed an improved short circuit current density and power conversion efficiency compared with solid TiO2 NP-based DSSCs due to the increase of the amount of inorganic dye (N719) adsorption in the mesoporous TiO2 NPs. These mesoporous TiO2 NPs fabricated have a strong potential as an effective dye supporting and electron transfer medium to improve the photovoltaic performance of DSSCs.
New MR imaging techniques that limit artifacts in the abdomen have increased the role of MR imaging in detection and characterization of pancreatic disease. Advantages of imaging at 3T compared with 1.5T include thinner section acquisition (typically 2.5 mm versus 5 mm at 1.5T), higher matrix (typically 340 × 516 compared with 192 × 256), and high quality of T1-weighted three-dimensional (3D) gradient echo imaging . Standard sequences at 3T, which include breath-hold T1-weighted 3D gradient echo sequences, fat suppression techniques, and dynamic administration of gadolinium chelate, have resulted in image quality of the pancreas sufficient to detect and characterize focal pancreatic mass lesions smaller than 1 cm in diameter, and to evaluate diffuse pancreatic disease. MR cholangiopancreatography (MRCP) images acquired in a coronal oblique projection to delineate the pancreatic and bile duct is a useful addition. MRCP permits good demonstration of the biliary and pancreatic ducts to assess ductal obstruction, dilation, and abnormal duct pathways. The combination of parenchyma-imaging sequences and MRCP provides comprehensive information to evaluate the full range of pancreatic disease.
We report a case of spontaneous tonsillar haemorrhage due to underlying von
Willebrand's disease, without symptoms or signs of infection.
Case report and literature review of reported causes of spontaneous tonsillar
Spontaneous tonsillar haemorrhage is uncommon. Acute bacterial tonsillitis,
peri-tonsillar abscess, infectious mononucleosis and idiopathic causes have been
reported. Two cases of tonsillitis with underlying bleeding disorders have been
reported. We present the first reported case of spontaneous tonsillar haemorrhage
secondary to von Willebrand's disease, without evidence of tonsillitis.
Spontaneous tonsillar haemorrhage is usually related to infection of the tonsils or
peri-tonsillar space. An underlying bleeding disorder should be suspected if no evidence
of infection is found.
The propensity to take risk underpins a wide variety of decision-making behavior, ranging from common ones such as asking for directions and trying out a new restaurant to more substantial economic decisions involving, for instance, one's investment or career. Despite the fundamental role of risk attitude in the economy, its genetic basis remains unknown. Using an experimental economics protocol combined with a classical twin strategy, we provide the first direct evidence of the heritability of economic risk attitude, at 57%. We do not find a significant role for shared environmental effects, a common observation in behavioral genetics that is contrary to commonly held views in economics. Our findings complement recent neuroeconomic studies in enhancing the understanding of the neurobiological basis of risk taking.
Simple cycloalkylsilanetriols RSi(OH)3 [R =c- pentyl (1</b>) and c-hexenyl (2b</b>)] were synthesized as white powders in 70% and 90% isolated yields, respectively, from the hydrolysis of the corresponding trialkoxysilanes with mild acidic water. Silanetriols 1</b>,2</b> are soluble in water and polar organic solvents such as alcohol, acetone, THF, DMSO, and etc. They can be applied as surface modifiers for inorganic materials such as silica and titania through simple two step processes: 1) organosilanetriol interact with hydroxyl groups on inorganic materials through hydrogen bonding to make molecular layered thin coating on the inorganic surface, 2) then can undergo condensation by heating about 110 ℃ above to form M-O-Si covalent bond to give hydrophobic silica. With the treatment of ca. 50 nm spherical silica with 5 wt % alkylsilaneol 1, no precipitation of silica particles in water was observed, indicating good surface modifiers for silica particle. In this presentation we will discuss the application of silanetriols as surface modifier for inorganic materials such as silica and titania particles.
We deposited various nano structured ZnO thin films with plasma treatment on an alumina substrate and fabricate ZnO sensors for acetone detection. The ZnO sensors with various nano structures and the plasma treatment were deposited by radio frequency (RF) magnetron sputtering method with RuO2 micro heater and Ru electrode. In order to control a work function intentionally, the various deposition conditions and the plasma treatment were used. Sensitivities of the ZnO sensor were measured in acetone vapor and air at 250 degree C. In conclusion, we suggested that the sensitivity of ZnO sensors for acetone strongly depends on the work function of the as-deposited or plasma treated nano structured ZnO thin films.
The low frequency noise of individual ZnO nanowire (NW) field effect transistors (FETs) exposed to air is systematically characterized. The measured noise power spectrum shows a classical 1/f type. The noise amplitude is independent of source-drain current and inversely proportional to gate voltage. The extracted Hooge's constant of ZnO NW is found to be 6.52×10−3. In addition, the low frequency noise of ZnO NW according to NW resistance and contact property are investigated. The noise amplitude is proportional to the square of ZnO NW resistance. If a sample shows a nonlinear current-voltage (I-V) characteristic due to a poor electrical contact, the noise power spectrum is proportional to the third power of current instead of the square of current.
Field effect transistors(FETs) made of ZnO nanowires are very sensitive to the gas environment, so that the passivation can be a good way to get reliable nanowire FETs with longer lifetime and the better mobility. The studies on the passivation effects with the positive electron-beam resist was investigated by selectively covering the part of nanowire devices between the electrodes. Reproducible electrical characteristics were recorded, reflecting the stable electrical properties by the passivation which deters the degradation of a device. Considering the defect states of oxide nanowires dominate the charge states, the pre-state just before the passivation process will be crucial to understand the reproducible and controllable device characteristics of nanowire devices.
Background: Clock-drawing tests are popular components of dementia screens but no single scoring system has been universally accepted. We sought to identify an optimal subset of clock errors for dementia screening and compare them with three other systems representative of the existing wide variations in approach (Shulman, Mendez, Wolf-Klein), as well as with the CDT system used in the Mini-Cog, which combines clock drawing with delayed recall.
Methods: The clock drawings of an ethnolinguistically and educationally diverse sample (N = 536) were analyzed for the association of 24 different errors with the presence and severity of dementia defined by independent research criteria. The final sample included 364 subjects with ≥5 years of education, as preliminary examination suggested different error patterns in subjects with 0–4 years of education and inadequate numbers of normal controls for reliable analysis.
Results: Eleven of 24 errors were significantly associated with dementia in subjects with ≥5 years of education, and six were combined to identify dementia with 88% specificity and 71% sensitivity: inaccurate time setting, no hands, missing numbers, number substitutions or repetitions, or refusal to attempt clock drawing. Time setting was the most prevalent error at all dementia stages, refusal occurred only in moderate and severe dementia; and ethnicity and language of administration had no effect. All critical errors increased in frequency with dementia stage. This simplified scoring system had much better specificity than two other systems (88% vs 39% for Mendez's system – 63% for Shulman's) and much better sensitivity than Wolf-Klein's (71% vs 51%). Stepwise logistic regression found the simplified system to be more strongly predictive of dementia than the three other CDT systems of dementia. Substituting the new CDT algorithm for that used in the original CDT Mini-Cog improved the Mini-Cog's specificity from 89 to 93% with minimal change in sensitivity.
Conclusions: Only six errors need be assessed to capture most of the power of clock drawing to discriminate between people with dementia and normal subjects, and improves specificity over older systems in subjects with ≥5 years of education. These errors require minimal conceptual classification and are easily detected and scored by non-specialists.